The Affordable Care Act and Whistleblower Lawsuits

Qui Tam Whistleblower ClaimsThe stated goal of the Affordable Care Act (ACA), also known as “Obamacare,” is to make healthcare affordable for the general public. With healthcare spending in the U.S in 2013 totaling $3 billion dollars, and projected to rise 6% annually, one can understand that healthcare costs are quite burdensome for individuals, families, and businesses.

While the ACA as a whole has received much media attention, one important aspect of the act has not. This portion of the law involves the enhancement of the False Claims Act (FCA) by which qui tam or whistleblower lawsuits are brought by individuals. These lawsuits bring fraudulent billing and other false claims in the healthcare industry to light. The FCA enables the government, with the help of private whistleblowers, to recover significant dollars that were fraudulently claimed as healthcare expenses. In 2013, some $2.6 billion was recovered from healthcare fraud cases.

While qui tam or whistleblower cases may be risky, whistleblowers do have an incentive to come forward with information regarding false claims and fraud against the government. Whistleblowers can receive 15-30% of what the government is able to recover as a result of a qui tam or whistleblower lawsuit. In 2013, FCA whistleblowers received $345 in incentive awards. This financial incentive is necessary to encourage private individuals to come forward, often at great personal sacrifice and expense, with information that helps taxpayers recoup billions of dollars lost annually to healthcare fraud, and to help ensure that fraud is minimized in these cases.

For more information regarding false claims and other fraudulent conduct the FCA prohibits healthcare facilities, providers, and drug manufacturers from engaging in, take a look at the The Affordable Care Act and Qui Tam Whistleblower Claims. This concise article, co-authored by Atlanta attorney Jay Brownstein, is quite informative on the topic.

Private Whistleblowers Help Fight Healthcare Fraud

The Primer on Whistleblowing in Healthcare, co-authored by Atlanta attorney Jay Brownstein, is an excellent resource regarding healthcare fraud. Healthcare fraud, including false and deceptive billing practices, costs taxpayers upwards of $80 billion each year. Healthcare fraud comes in many shapes and varieties, including fraudulent billing, kickback schemes, and other illegal practices. With Medicare and Medicaid paying the majority of these expenses, taxpayers ultimately pay the bill for healthcare fraud.Healthcare Fraud Spends Tax Dollars

In their article, Jay Brownstein and Kevin Little educate the public on what whistleblowing is, how it relates to the area of healthcare fraud, and what to do should healthcare fraud be suspected. They point out that healthcare providers and employees need to be aware of their rights, as there are many state and federal laws in place to protect them in whistleblowing instances. Additionally, an outline of what to look for in billing fraud, illegal referral fees or kickback schemes, and drug manufacturer or medical device fraud is included. The article also identifies steps to take to help protect oneself before reporting fraud or wrongdoing in the healthcare industry.

Each year, many courageous private citizens bring qui taim, or whistleblower lawsuits, to help the government recover billions of dollars in fraudulent healthcare claims. The Primer on Whistleblowing in Healthcare is a quick, informative read for those interested in the topic.

Shocked by those hospital bills? You are not alone.

Have you ever looked at a hospital bill with utter disbelief? You are not alone. Medical bills are the number one cause of personal bankruptcy filings in the United States. The cost of hospital care can be extraordinary, especially in light of the fact that many hospitals are operated as non-profits. Exacerbating the problem is the fact that most often patients in need of urgent care have no ability or opportunity to comparison shop. Hospitals essentially operate free from market constraints.

Medical BillsIt has recently come to light that due to the manner in which hospitals establish pricing for services, the retail or gross charges to patients (before insurance payments or discounts) are entirely arbitrary. Last year, author Steven Brill outlined some of the exorbitant costs of medical care in an important Time magazine special report titled “Bitter Pill”. Using the specific examples and powerful personal narratives of ordinary people who have suffered from unreasonably high medical expenses, Brill has exposed previously hidden truths about our healthcare system that help unravel the mystery of spiraling healthcare costs. Hopefully, Brill’s research and undeniable conclusions will help create a level playing field for the general public and policymakers in understanding how to combat and perhaps one day solve the problem.

One element of Brill’s research that seemed the most surprising was the existence and function of a hospital “chargemaster.” Before “Bitter Pill,” most of us had likely never heard of a chargemaster. As the name hints, a chargemaster is responsible for assigning the retail charges for all medical procedures, services, medications and supplies at a hospital. Using supporting visual references such as hospital bills and receipts, Mr. Brill does a superb job of documenting how charges can vary depending on a patient’s coverage. One example he uses is that of a chest X-ray in which a patient was charged $333.00. The same X-ray is covered for a Medicare patient at a rate of $23.83. Another example is a case in which a patient is charged $1.50 for one acetaminophen tablet (acetaminophen is the main ingredient found in the brand name painkiller Tylenol). The price for one tablet is in the same ballpark as what an entire bottle of the generic drug may be purchased for.

Bitter Pill is a great stepping stone into the discussion of fraudulent billing. More information can be found regarding the matter of fraudulent billing of Medicaid in the Primer on Whistleblowing in Healthcare , an article co-authored by Brownstein & Nguyen attorney Jay Brownstein. An experienced attorney who handles complex litigation matters, Jay Brownstein has consulted and represented clients in whistleblower cases. If you suspect that you have been overbilled or “up-coded” as a result of a hospital or nursing home stay, contact our trusted Atlanta attorneys for a free consultation regarding healthcare whistleblowing.

Buyer Beware: Online Legal Forms & Non-Lawyer Services

If you’ve ever been tempted to use a point-and-click legal form or other non-lawyer service offered online by numerous websites, you’re not alone. According to the U.S. Bureau of Economic Statistics, in 2012 U.S. households spent over $8 billion on legal services, a 33% increase from 2005. For some consumers, online forms and other legal services appear to offer inexpensive alternatives to hiring an attorney for what they consider are “simple” legal matters, such as wills and contracts. However, there can be unforeseen dangers and hidden costs to utilizing online forms and non-lawyer legal services for personal or business matters.

Business Litigation AtlantaWhile online forms and legal services websites might appear to be easy to use and relatively inexpensive, they can actually end up costing much more than hiring an attorney to perform the same tasks. This is true mainly because there is no such thing as a standard, “one size fits all” contract, will or legal matter, nor is there any substitute for personal legal advice following a direct consultation with a licensed attorney experienced in the relevant law in your state. Just as no two people are exactly alike (except perhaps identical twins), every legal situation is unique and must be carefully analyzed to determine the proper approach and needed solution.

Not only are lawyers knowledgeable in the laws of the state(s) where they are licensed, but they are also professionally trained to gather and sift through facts and identify important legal issues that should be addressed under the circumstances. With standardized forms (even ones purporting to be “valid” in particular states), there is a greater chance that relevant details will be missed and that the form selected and filled out by a consumer will either fail to adequately cover important legal issues or will not comply with applicable state law, or worse, both.

Unfortunately, as more consumers look to online forms and services instead of obtaining personal legal advice for their particular situation, many will find themselves dealing with the unintended cleanup efforts that can result. The story of Ann Aldrich illustrates the serious consequences that can arise when using online forms to create important legal documents such as wills or contracts. In Ms. Aldrich’s case, she created a last will using a form provided by online provider E-Z Legal Forms. Unfortunately, the form did not contain the necessary language to carry out Ms. Aldrich’s intent, which was to leave her entire estate to her sister first and then to Ms. Aldrich’s brother if her sister died before she did. The Florida Supreme Court ruled in favor of two nieces who challenged the will, holding they were entitled to receive bank accounts that were not specifically listed in the will. Not only were Ms. Aldrich’s true wishes not carried out, but unnecessary and costly litigation resulted from the defective will.

If something is worth doing – such as memorializing a business deal with a well-written contract or leaving clear instructions on passing your worldly belongings to your heirs – it is worth doing correctly. Taking shortcuts in important legal matters often leads to headaches and heartache as families, business partners and courts are left to figure out what actually was intended.

The Atlanta business litigation and counsel lawyers of Brownstein and Nguyen offer years of experience and legal expertise in business representation. No matter the legal issue, our lawyers will meet with you to discuss your particular situation, review your documents and offer advice on the legal issues presented, and prepare the necessary legal documents to proactively protect your business interests and anticipate potential future issues. If a dispute arises, our attorneys can effectively and efficiently represent your interests in court. Contact us today for assistance with your legal business needs.

Preventable Deaths from Medical Negligence

In a September 2013 article, the Journal of Patient Safety reported that patient deaths as a result of medical errors are on the rise. The article estimates that the range of annual premature deaths that are associated with preventable harm in hospitals is between 210,000 and 400,000. This estimate represents a significant increase from the reported range in the 1999 article To Err Is Human: Building a Safer Health System, which estimated the annual range of premature deaths to be between 44,000 and 98,000.

39169436These articles and the research behind them point to a harsh and unfortunate reality: our health care system is not safer and is failing to take necessary steps to prevent death and serious injury resulting from medical mistakes. In fact, the problem has gotten much worse. An increase of between 400 and 500 percent in 15 years in the number of preventable deaths from human error is totally unacceptable. In 1999, the authors of To Err Is Human outlined several steps recommended by the Quality of Healthcare in America Committee of the Institute of Medicine to improve safety and help decrease the number of preventable deaths and injuries. Some of these suggestions seem obvious, such as implementing better hygiene and patient safety protocols for the delivery of care to reduce mistakes such as preventable infections and medication errors. Apparently, either these suggestions have not been implemented industry-wide or they have been ineffectively implemented.

Perhaps the health care industry as a whole should revisit the original strategy for the improvement of care proposed by the Institute of Medicine.  That proposal included a four-tiered approach, which included:

  • Establishing a national focus to create leadership, research, tools, and protocols to enhance the knowledge base about safety.
  • Identifying and learning from errors by developing a nationwide public mandatory reporting system and by encouraging health care organizations and practitioners to develop and participate in voluntary reporting systems.
  • Raising performance standards and expectations for improvements in safety through the actions of oversight organizations, professional groups, and group purchasers of health care.
  • Implementing safety systems in health care organizations to ensure safe practices at the delivery level.

For the victims of medical mistakes and their families, the devastating losses associated with these errors such as overdosing patients and other medication errors, surgical mistakes, and acting on incomplete or incorrect patient health histories, do not make sense. How does one come to accept that their loved one’s death was the result of an error? How does one recover from such a devastating and preventable loss?

Atlanta law firm, Brownstein and Nguyen, has first hand knowledge and experience in working with families who have suffered tragic losses from preventable deaths and serious injuries due to medical mistakes. We are dedicated to advocating for families and loved ones who suffer. For more information about medical malpractice and negligence cases, click here. Contact us today for a free consultation and case review.

Immigration: Reform or Not, We are Here to Help

For the past several years, immigration reform has been a hot topic in our country as evidenced by frequent news headlines and reports about the many individuals and families caught in the middle. The general consensus seems to be that changes to current immigration policy and laws are needed. Some reforms – including a path to citizenship for those who entered or stayed in the United States illegally but have become productive members of society – even have broad support. Unfortunately, however, the political stalemate in Washington has prevented legislation from being enacted. For the countless immigrants seeking to become citizens or who are facing possible deportation, change cannot come soon enough.

Immigration Law-AtlantaImmigration laws and procedures are not simple, but rather are extremely complicated. For those needing relief, the U.S. immigration system is daunting and should not be faced alone. At Brownstein & Nguyen, our attorneys are intimately familiar with the many complex aspects of immigration law and the legal process involved. Even within the current system, that can seem overwhelming and often leads to harsh and unintended results, we can make a difference for clients. While we may not be able to effect broader changes in policy or the law, over the years we have successfully helped thousands of clients to fulfill their dreams of living and prospering in our great nation.

For example, we have helped individuals and families seeking to enter or stay in the United States by obtaining the appropriate type of visa. Visas mean all the difference in the world for so many, as families can be reunited, students can gain college educations, and gainful employment can be legally obtained.

An opinion piece in USA today gave a Last Call for Obama on Immigration Reform. At Brownstein and Nguyen, we are here to help those in need to navigate an immigration system waiting for change, so they can improve the quality of their lives and their families’ futures.

For more information on immigration issues, please feel free to read through the information found in our Immigration Practice pages. If you or someone you know is experiencing an immigration problem or has an immigration question, please do not hesitate to contact our Atlanta immigration specialists at Brownstein and Nguyen.

Welcome to the Brownstein and Nguyen Atlanta Law Firm Blog

Thank you for stopping by our website and visiting our blog. Our goal is to provide you with helpful resources and information on legal topics in our areas of practice – immigration, business litigation and personal injury. While many other firms also practice in these areas, we believe that our passion, our experience, and our commitment to our clients’ needs help us stand out above the rest.

Trusted Atlanta Immigration LawyerOur Passion

We are passionate about the areas of law in which we practice in the greater Atlanta area. Through personal attention, diligence and perseverance we treat each client’s case as the most important one in the firm. We truly want to make a difference in our clients’ lives and help them through their legal difficulties.

Our Experience

Take a few minutes to browse our case results and testimonials – we believe these speak volumes to the expertise and skill Brownstein and Nguyen brings to the table for our clients. Established over twenty years ago, the longevity of our firm proves we are here to stay. It has also allowed founding lawyers, Jay Brownstein and Tien Nguyen, to gain a wealth of experience in their respective areas or practice. Click here to learn more about our attorneys.

Our Commitment

We are absolutely committed to upholding the highest standards in practicing law. With this comes a deep commitment to each of our clients. We strive for personalized service for each client, as we know that each legal situation and need is different. We make sure that professionalism, honesty, advocacy, and work ethic are the forefront of our practice.

Contact Us

If you are in need of legal help and interested in getting the process started, contact Brownstein and Nguyen – your immigration, business litigation, and personal injury law specialists in Atlanta, GA.

Three Key Things to Consider when Looking for an Assisted Living Facility

With the effects of Alzheimer’s disease often requiring special care, it is highly likely that the number of families that must turn to a Skilled Nursing Facility (or nursing home) will rise. In searching for a facility for your loved one, there are many things to consider. Here are three key things that you should keep in mind:

Researching a Skilled Nursing Facility1. Research Facilities In Advance

Before visiting a specific facility, do your research. Visit sites such as and the Georgia Department of Community Health to review facility ratings and reports. Look closely at the numbers of complaints and violations if there are any.

2. Visit the Facility

After carefully researching the facilities and determining which ones may best meet the care needs of your loved one, set up an appointment to visit. This can easily be done through calling or emailing the facility to schedule a tour and meet with an onsite administrator. Make sure that you observe the residents, the employees, and the overall environment while visiting.

3. Ask Questions

It is wise to be prepared with questions before visiting a facility. Think about what you would like to ask the manager, the healthcare providers, and even the residents. The National Institute on Aging provides several suggested questions. This is a big decision, and it is important to investigate all angles.

While researching and visiting facilities, it is important to be aware of any signs of nursing home neglect or elder abuse. You will want to make sure that you address any questions or concerns that you have regarding any potential warning signs in this area. It may also be helpful to consult with a lawyer that is familiar with cases of nursing home neglect or abuse prior to visiting a facility and before agreeing to admit a family member. At Brownstein & Nguyen, we have years of experience in dealing with the difficult situations that arise in cases of nursing home neglect and elder abuse. Call or contact us today so that we can help you.

Jay Brownstein featured in blog “Listen Like a Lawyer”

See Jay Brownstein’s thoughts on the different listening contexts for trial lawyers in the blog “Listen Like a Lawyer,” hosted by Emory Law professor Jennifer Romig.  Jay discusses listening skills used by lawyers when communicating with clients (before and after engagement), trial judges, juries and appellate panels. Click here to read the posting.